Blank TIN Form~31.docx
DOCX document 30 KB Posted
- Attached to
- Lawn Care D0198 Oak Park
- Solicitation number
- 27-416CMS-BOPM4-B-54646
- Issued by
- Cook County, Illinois
About this file
This is a Taxpayer Identification Number (TIN) form issued by the State of Illinois for use in conjunction with a lawn care services contract solicitation at D0198, 445 West Harrison Street, Oak Park, Illinois 60304. The form is designed to collect essential identification information from prospective contractors prior to contract award. Bidders are required to provide their legal business name, taxpayer identification number (either Social Security Number for individuals or Employer Identification Number for entities), and certify their tax compliance status. The form accommodates various business structures including individuals, sole proprietors, partnerships, corporations, limited liability companies, and tax-exempt entities, with specific instructions for each classification type.
This form serves as a prerequisite documentation requirement for contractors responding to the open solicitation for lawn care services. Prospective bidders must complete the TIN form with accurate information and provide appropriate supporting documentation as specified for their legal status category, such as IRS acceptance letters for corporations. The completed form certifies that the bidder's taxpayer identification number is correct and that the bidder is not subject to backup withholding under IRS regulations. This documentation is standard for state contracting purposes and must be submitted as part of the overall bid package to establish contractor eligibility and ensure compliance with Illinois state procurement requirements.
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Other files
| File | Type | Posted |
|---|---|---|
| standard-illinois-certifications-v-26-2~67.pdf | ||
| Lawn Care Contract D0198 Oak Park.docx | DOCX document | |
| Lawn Care D0198 Oak Park Property Image.docx | DOCX document |
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Text version
STATE OF ILLINOIS
TAXPAYER IDENTIFICATION NUMBER
I certify that:
The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and I am a U.S. person (including a U.S. resident alien).
· If you are an individual, enter your name and SSN as it appears on your Social Security Card.
· If you are a sole proprietor, enter the owner’s name on the name line followed by the name of the business and the owner’s SSN or EIN.
· If you are a single-member LLC that is disregarded as an entity separate from its owner, enter the owner’s name on the name line and the D/B/A on the business name line and enter the owner’s SSN or EIN.
· If the LLC is a corporation or partnership, enter the entity’s business name and EIN and for corporations, attach IRS acceptance letter (CP261 or CP277).
· For all other entities, enter the name of the entity as used to apply for the entity’s EIN and the EIN.
Name:
Business Name:
Taxpayer Identification Number:
Social Security Number:
or Employer Identification Number:
Legal Status (check one):
| |_| Individual | |_| Governmental | ||||
| |_| Sole Proprietor | |_| Nonresident alien | ||||
| |_| Partnership | |_| Estate or trust | ||||
| |_| Legal Services Corporation | |_| Pharmacy (Non-Corp.) | ||||
| |_| Tax-exempt | |_| Pharmacy/Funeral Home/Cemetery (Corp.) | ||||
| |_| Corporation providing or billing | |_| Limited Liability Company | ||||
| medical and/or health care services | (select applicable tax classification) | ||||
| |_| Corporation NOT providing or billing | |_| C = corporation | ||||
| medical and/or health care services | |_| P = partnership |
Signature of Authorized Representative:
Date: Click here to enter a date.
File details come from the government source that posted it. Updated .